Complications and complication handling of pancreatic stent

Complications and complication handling of pancreatic stent

The most common complication of pancreatic stent is stent obstruction

It happens 5% ~ 20% among all the cases. In clinical practice, stent with larger diameter is not easy to get obstructed, while 50% 10FR plastic stent could be obstructed 6~12 months after implantation.

Most of the obstructions are mixtures of cellular debris, calcium carbonate crystals, calcium erythrin and bacteria. Protein adhesion on stent could be the main reason of obstruction.  The solution of stent obstruction is to remove the obstructed stent and implant a new one.  

Stent falling off

Stent falls off from the position and leaves the body by defecation. No adverse reaction.

Stent migration

The common device used to treat stent migration is Soehendra, teeth forceps, stone retrieval basket.

Stent embedment

Retrieve the stent by endoscopic operation of open surgery.

Stent causing morphological changes of pancreas

This is the exclusive complications of pancreatic stent. The occurrence rate is 80%, among which irregular pancreatic duct accounts for 49%, narrow pancreatic accounts for 35.5%, dilated pancreatic duct accounts for 15.5%. Most cases are irreversible.

Strictly understand the indications of pancreatic plastic stent implantation would be very important, they are:

Chronic pancreatitis with pancreatic duct stenosis and intractable abdominal pain

Adjuvant therapy of pancreatic duct stones in chronic pancreatitis;

Pancreatic schizophrenia;

Pancreatic pseudocyst;

Internal fistula formed by traumatic pancreatic duct rupture;

Pancreatic ascites

Conservative treatment of pancreatic duct stenosis caused by ampullary and pancreatic malignant tumors, papillary mucinoma in pancreatic duct, etc.

Prevent pancreatitis after ERCP.

Information from —Gastrointestinal stent , Nanjing Jiangsu Scientific and Technology Press